發(fā)布時間：2018-09-13 21:38

【摘要】：目的:通過對青年人與老年人胃癌患者的臨床病理特點進行對比分析,探討青年人胃癌和老年人胃癌的共同點和不同點,從而為胃癌的預(yù)防和治療提供理論依據(jù)。方法及資料:分別對青年及老年胃癌患者的性別、臨床癥狀、家族史、腫瘤標(biāo)志物(CEA)、腫瘤發(fā)生部位、胃鏡下大體分型、組織學(xué)分型、臨床分期、手術(shù)治療情況分別進行對比分析�；仡櫺苑治�2006年1月至2015年12月吉林大學(xué)中日聯(lián)誼醫(yī)院收治的112例具有完整臨床資料的胃癌患者,均經(jīng)胃鏡病理或術(shù)后病理明確診斷,伴有其他原發(fā)性惡性腫瘤者不予納入研究對象。我們將≤30歲患者歸為青年組,≥70歲患者歸為老年組,其中青年組患者42例,老年組患者70例。統(tǒng)計分析采用SPSS21.0統(tǒng)計學(xué)軟件,數(shù)據(jù)差異采用X~2檢驗,P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:(1)性別:青年組女性較男性常見,男女比例為:1:1.3,女性占57.14%;老年組男性較女性多見,男女比例為:2.33:1,男性占70%,兩組間男女發(fā)病率比較差異有統(tǒng)計學(xué)差異(P0.05)。(2)臨床癥狀:青年組和老年組患者均以腹痛為主,青年組患者中約占57.14%,老年組患者中約占80%,兩組比較差異具有統(tǒng)計學(xué)意義(P0.05);青年組患者中有嘔血、黑便癥狀者占33.33%,老年組占17.14%,其差異比較具有統(tǒng)計學(xué)意義(P0.05);老年組患者出現(xiàn)吞咽困難、胸骨后不適、消瘦癥狀均高于青年組,兩組差異比較均具有統(tǒng)計學(xué)意義(P0.05);老年組患者出現(xiàn)貧血、食欲減退、腹部包塊癥狀均高于青年組,其它臨床癥狀兩組之間比較均無統(tǒng)計學(xué)意義(P0.05)。(3)家族史:青年組有家族史者占19.05%,老年組有家族史者占2.86%,兩組家族史比較差異有統(tǒng)計學(xué)意義(P0.05)。(4)腫瘤標(biāo)志物:青年組CEA升高者占14.29%,老年組CEA升高者占17.14%,兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。(5)發(fā)病部位:青年組好發(fā)部位是胃竇,青年組患者占61.90%,老年組患者占34.29%,其差異比較具有統(tǒng)計學(xué)意義(P0.05);青年組胃體部發(fā)病率比老年組略低,其差異比較無統(tǒng)計學(xué)意義(P0.05);青年組胃底賁門處發(fā)病患者占9.52%,低于老年組的37.14%,其差異比較具有統(tǒng)計學(xué)意義(P0.05),青年組胃廣泛癌發(fā)病率比老年組略高,兩組差異比較無統(tǒng)計學(xué)意義(P0.05)。(6)胃鏡下大體分型:青年組以Borrmann Ⅲ、Borrmann Ⅳ型為主,老年組以Borrmann II、Borrmann Ⅲ型為主,其中青年組Borrmann Ⅳ型的構(gòu)成比為33.33%,高于老年組的17.14%,其差異進行統(tǒng)計學(xué)處理具有意義(P0.05);青年組Borrmann I型患者占4.76%,明顯低于老年組的18.57%,其差異進行統(tǒng)計學(xué)處理具有意義(P0.05)。Borrmann II、Borrmann Ⅲ型兩組比較差異均無統(tǒng)計學(xué)意義(P0.05)。(7)組織學(xué)分型:青年組低分化腺癌、印戒細胞癌的比例分別為42.86%、16.67%,高于老年組的17.14%、4.29%,兩組分別比較差異都具有統(tǒng)計學(xué)意義(P0.05);青年組高分化腺癌、中分化腺癌患者分別占4.76%、9.52%,低于老年組的18.57%、34.29%,兩組比較差異都具有統(tǒng)計學(xué)意義(P0.05);粘液腺癌、未分化癌及其他特殊類型癌分別進行數(shù)據(jù)處理,都沒有統(tǒng)計學(xué)意義(P0.05)。(8)臨床分期:青年組以Ⅲ、Ⅳ期為主,老年組II、Ⅲ、Ⅳ期均常見。其中青年組Ⅳ期患者約45.24%,明顯高于老年組的25.71%,其差異比較具有統(tǒng)計學(xué)意義(P0.05);青年組II期患者約占9.52%,明顯低于老年組的25.71%,比較差異具有統(tǒng)計學(xué)意義(P0.05)。I、Ⅲ期患者所占比例兩組比較差異都沒有統(tǒng)計學(xué)意義(P0.05)。(9)手術(shù)治療情況:青年組和老年組患者接受手術(shù)治療者分別占76.19%、80%,其差異無統(tǒng)計學(xué)意義(P0.05);青年組接受根治性手術(shù)的占47.62%,低于老年組的67.14%,青年組接受姑息手術(shù)的占28.57%,高于老年組的12.86%,兩組比較差異均具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:1.青年胃癌患者女性較常見,老年胃癌患者男性為主,青年胃癌患者有較多的家族史。2.青年胃癌患者以胃竇多見,以消化道出血為主要表現(xiàn);老年組胃癌以胃底賁門多見,消化功能障礙為主要表現(xiàn)。3.青年胃癌病理分型較差,分期較晚,獲得根治性手術(shù)比例較低。
[Abstract]:Objective:To explore the similarities and differences between young and old patients with gastric cancer by comparing the clinicopathological characteristics of young and old patients, so as to provide theoretical basis for the prevention and treatment of gastric cancer. A retrospective analysis of 112 cases of gastric cancer with complete clinical data admitted to the Sino-Japanese Friendship Hospital of Jilin University from January 2006 to December 2015 was made. Patients with other primary malignant tumors were not included in the study. We classified the patients younger than 30 years old into the youth group and those older than 70 years old into the elderly group, including 42 cases in the youth group and 70 cases in the elderly group. Young women were more common than men, the ratio of male to female was 1:1.3, women accounted for 57.14%; elderly men were more common than women, the ratio of male to female was 2.33:1, male accounted for 70%. There was a significant difference between the two groups in the incidence of male and female (P 0.05). (2) Clinical symptoms: young group and elderly group were mainly abdominal pain, young group accounted for 57.14%, elderly group about 57.14%. The difference between the two groups was statistically significant (P 0.05); 33.33% of the young group had hematemesis, and 17.14% of the elderly group had melena symptoms; the difference was statistically significant (P 0.05); the elderly group had dysphagia, sternal discomfort, and wasting symptoms were higher than the young group; the differences between the two groups were statistically significant (P 0.05). (3) Family history: 19.05% of the young group had family history, 2.86% of the elderly group had family history, and there was a significant difference between the two groups in family history (P 0.05). (4) Swelling. Tumor markers: 14.29% of the young group increased CEA, 17.14% of the elderly group increased CEA, there was no significant difference between the two groups (P There was no significant difference between the two groups (P 0.05). The incidence of extensive gastric cancer in the youth group was slightly higher than that in the elderly group (P 0.05). There was no significant difference between the two groups (P 0.05). The incidence of extensive gastric cancer in the youth group was 9.52% and 37.14% respectively. The proportion of Borrmann type IV in young group was 33.33%, which was higher than 17.14% in old group. The difference was statistically significant (P 0.05). The proportion of Borrmann type I in young group was 4.76%, which was significantly lower than 18.57% in old group. Significance (P 0.05). There was no significant difference between Borrmann II and Borrmann III (P 0.05). (7) Histological classification: the proportion of poorly differentiated adenocarcinoma and signet ring cell carcinoma in young group was 42.86%, 16.67% respectively, higher than that in old group (17.14%, 4.29%). There was significant difference between the two groups (P 0.05). Patients with moderately differentiated adenocarcinoma accounted for 4.76%, 9.52%, lower than 18.57%, 34.29% of the elderly group, the difference between the two groups was statistically significant (P 0.05); mucinous adenocarcinoma, undifferentiated carcinoma and other special types of cancer data processing, respectively, were not statistically significant (P 0.05). (8) Clinical stage: Youth group with stage III, IV mainly, the elderly group with stage II, III, IV. The youth group stage IV patients were 45.24%, significantly higher than the elderly group 25.71%, the difference was statistically significant (P 0.05); youth group stage II patients accounted for 9.52%, significantly lower than the elderly group 25.71%, the difference was statistically significant (P 0.05). I, the proportion of patients with stage II I between the two groups was not statistically significant (P 0.0). (9) Surgical treatment: 76.19% of the youth group and 80% of the elderly group received surgical treatment, the difference was not statistically significant (P 0.05); 47.62% of the youth group received radical surgery, lower than 67.14% of the elderly group; 28.57% of the youth group received palliative surgery, higher than 12.86% of the elderly group; the difference between the two groups was statistically significant. Significance (P 0.05). Conclusion: 1. Young patients with gastric cancer are more common in women, elderly patients with gastric cancer are mainly male, young patients with gastric cancer have more family history. 2. Young patients with gastric cancer are more common in gastric antrum, with gastrointestinal bleeding as the main manifestation; elderly patients with gastric cancer are more common in gastric fundus and cardia, digestive dysfunction as the main manifestation. Later, the rate of radical surgery was relatively low.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2

【相似文獻】

相關(guān)期刊論文 前10條

1 于吉人,梁廷波,沈倩云;老年人胃癌的臨床特點[J];浙江醫(yī)學(xué);2000年10期

2 黃小榮;浙北地區(qū)老年人胃癌612例分析[J];浙江臨床醫(yī)學(xué);2001年01期

3 張素云,陳利霞;老年人胃癌280例分析[J];河北醫(yī)藥;2002年08期

4 陳元生,張海森;老年人胃癌27例報告[J];江西醫(yī)學(xué)院學(xué)報;2003年04期

5 黃育萬;老年人胃癌的治療[J];老年醫(yī)學(xué)與保健;2003年01期

6 王克振;老年人胃癌418例臨床分析[J];中國冶金工業(yè)醫(yī)學(xué)雜志;2003年03期

7 林海清;老年人胃癌的外科治療[J];浙江醫(yī)學(xué);2003年06期

8 安澤武,王茹,宋少柏;老年人胃癌65例的外科治療[J];中華胃腸外科雜志;2003年05期

9 欒復(fù)新,王孟薇;血小板增多與老年人胃癌臨床病理因素及預(yù)后關(guān)系[J];中華老年醫(yī)學(xué)雜志;2004年04期

10 李芳霞,呂軍寧,潘立紅;老年人胃癌171例分析[J];實用醫(yī)技雜志;2004年13期

相關(guān)會議論文 前7條

1 黃智銘;陳旭艷;吳金明;吳建勝;陳向榮;陳民新;韓清錫;;青年人與老年人胃癌的臨床特點和病理分析[A];中華醫(yī)學(xué)會第七次全國消化病學(xué)術(shù)會議論文匯編（下冊）[C];2007年

2 黃智銘;陳旭艷;吳金明;吳建勝;陳向榮;陳民新;韓清錫;;青年人與老年人胃癌的臨床特點和病理分析[A];浙江省中西醫(yī)結(jié)合學(xué)會消化專業(yè)第八次學(xué)術(shù)年會暨省中西醫(yī)結(jié)合消化系疾病新進展學(xué)習(xí)班論文匯編[C];2007年

3 黃智銘;陳旭艷;吳金明;吳建勝;陳向榮;陳民新;韓清錫;;青年人與老年人胃癌的臨床特點和病理分析[A];2007年浙江省消化系疾病學(xué)術(shù)會議論文匯編[C];2007年

4 陳旭艷;黃智銘;吳金明;吳建勝;陳向榮;陳民新;韓清錫;;青年人與老年人胃癌的臨床特點和病理分析[A];第一屆全國老年消化內(nèi)鏡和消化道疾病研討會論文匯編[C];2008年

5 黃永剛;王國良;葉金明;房房;周娟娣;陳輝;瞿麗;謝達飛;;快速康復(fù)外科微創(chuàng)理念在老年人胃癌患者圍手術(shù)期的應(yīng)用[A];2012年浙江省外科學(xué)學(xué)術(shù)年會論文集[C];2012年

6 黃永剛;王國良;葉金明;房房;周娟娣;陳輝;瞿麗;謝達飛;;快速康復(fù)外科微創(chuàng)理念在老年人胃癌患者圍手術(shù)期的應(yīng)用[A];2012浙江省微創(chuàng)外科年會論文集[C];2012年

7 何慧療;;胃腸充盈造影篩查中老年人胃癌的價值[A];2011年浙江省超聲醫(yī)學(xué)學(xué)術(shù)年會論文匯編[C];2011年

相關(guān)重要報紙文章 前2條

1 陳杰;老年人胃癌的特點[N];農(nóng)村醫(yī)藥報（漢）;2005年

2 陳杰;老年人胃癌的特點[N];家庭醫(yī)生報;2005年

相關(guān)碩士學(xué)位論文 前9條

1 牛波波;老年人胃癌淋巴結(jié)轉(zhuǎn)移規(guī)律的臨床研究（附3183例臨床分析）[D];河北醫(yī)科大學(xué);2015年

2 施志杰;青年人與老年人胃癌臨床病理特點及對比分析[D];吉林大學(xué);2017年

3 孟春燕;腹腔鏡輔助胃癌根治術(shù)在老年人胃癌中的應(yīng)用[D];福建醫(yī)科大學(xué);2011年

4 陳松;老年人胃癌預(yù)后的相關(guān)因素分析[D];福建醫(yī)科大學(xué);2013年

5 萬文明;青年及老年人胃癌的臨床病理學(xué)特點及對比分析[D];南昌大學(xué);2011年

6 彭鑫宇;老年人胃癌生物學(xué)行為與外科治療的研究（附4015例臨床分析）[D];河北醫(yī)科大學(xué);2011年

7 鄭潔;青老年人胃癌及癌旁組織p53 PCNA nm23表達及病理因素對比研究[D];山東大學(xué);2008年

8 何琳莉;青年和老年人胃癌組織中cystatin C,cathepsin B,EGFR表達及其意義[D];川北醫(yī)學(xué)院;2014年

9 張永強;老年人胃癌中醫(yī)證型的探討[D];成都中醫(yī)藥大學(xué);2007年

，

本文編號：2241818